COMMENT
JOURNAL ARTICLE

Dentists consider medical screening important and are willing to incorporate screening procedures into dental practice

Brian Laurence
Journal of Evidence-based Dental Practice 2012, 12 (3): 32-3
23253828

SUBJECTS: Subjects were 1945 respondents from a survey sent out to 7400 general dentists practicing in the United States (26% response rate). The 7400 dentists were from a random sample generated from the American Dental Association (ADA) master file, which included ADA members and nonmembers. Among respondents, 82.3% were male, 85.7% were white, and 84.8% were 40 years of age or older. The study sample was different from the total sampling frame of US practicing dentists in that the respondents in this sample included older individuals, fewer women, and fewer Asian Americans and African Americans.

KEY RISK/STUDY FACTOR: No one independent variable was identified, as the study was exploratory and not driven by a specific hypothesis. Demographic information was obtained about each respondent's sex, age, race/ethnicity, location of practice, and years in practice.

MAIN OUTCOME MEASURE: No one outcome was identified, as the purpose of the study was to obtain information about dentists' attitudes, acceptance of, and perceived barriers to performing medical screening in a dental setting. The questionnaire included 5 Likert scale questions that used a 5-point response scale as follows: 1 = very important/very willing, 2 = somewhat important/somewhat willing, 3 = not sure, 4 = somewhat unimportant/somewhat unwilling, and 5 = very unimportant/very unwilling. A Friedman 2-way nonparametric analysis of variance (ANOVA) was used for the analyses with Wilcoxon-Mann-Whitney mean rank sum value provided when the ANOVA test yielded a significant difference.

MAIN RESULTS: The authors combined the first 2 responses "very important" and "somewhat important" to create one variable "important" to score Questions 1 and 2. As a result, most thought it was important to conduct screening for hypertension (85.8%), cardiovascular disease (76.8%), diabetes mellitus (76.6%), hepatitis (71.5%), and human immunodeficiency virus (68.8%). The authors combined the responses "very willing" and "somewhat willing" to create one variable "willing" to score Question 3. The result was that most were willing to conduct screening that yielded immediate results (83.4%), to discuss results immediately with the patient during the dental visit (76.0%), or refer a patient for a medical consultation (96.4%). Only 45.9% were willing to send samples to a laboratory for testing. Using the same coding scheme for Question 4 as was used for Question 3, the authors found that most respondents (87.7%) were willing to collect oral fluids and blood pressure measurements (90.8%). Respondents were less willing to collect blood via finger stick (55.9%) or measure height and weight (57.4%). For Question 5, 54.7% thought that having insurance coverage was "very important" in deciding whether to incorporate medical screening into dental practice, compared with 75.4% for the variable categorized as time, 76.1% for the variable costs, 82.4% for the variable liability, and 83.5% for the variable described as patient willingness. According to the authors, the results suggest that having insurance is the least important barrier to incorporating screening into the dental practice. The authors also performed subgroup analysis according to sex and years of practice, observing some differences with the former but none with the latter. Women were more willing to test for hypertension, cardiovascular disease, and diabetes mellitus and thought that having insurance coverage was more important compared with men when considering whether to incorporate medical screening into dental practice. No mention was made of subgroup analysis according to locale (urban, suburban, and rural). Comparing the mean rank sums, insurance was significantly less important than time, cost, liability, or a patient's willingness when deciding whether or not to incorporate screening (P < .001).

CONCLUSIONS: Most respondents thought that chairside screening for medical conditions was important and were willing to conduct screening for specified medical conditions in a dental setting.

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